How should policymakers approach e-cigarettes?

The Hong Kong government is proud of its tobacco control efforts. The rate of smoking among the adult population is now below 20 percent. Officials believe they can get the number down to below 10 percent in the years ahead.

This generally positive trend has been disrupted by new technology. Some time ago, the tobacco industry saw its business starting to decline, especially in the developed world. It started to research products that would be less harmful to users, or annoying to others.

The result is e-cigarettes. This phrase refers to several different types of smoking devices, but the controversy over them is pretty much the same.

According to the industry, these products do less harm than traditional cigarettes. Some health professionals agree that e-cigarettes are probably less harmful than the traditional sort – but not all do.

Hong Kong does not yet have comprehensive legislation covering these relatively new products. Our laws and regulations on ordinary cigarettes are quite tough – with strict laws against advertising and promotions, and hefty taxes applied to the products.

How should policymakers approach e-cigarettes? It is an interesting example of an issue where it is very difficult to get a consensus.

The government raised this issue several years ago, and in fact proposed a complete ban on e-cigarettes. A fairly fierce debate followed.

On one side of the debate we have the industry. Needless to say, they are in favor of legal status for the products, with the lightest regulation possible. They have a commercial interest in this.

Among other voices in support are people who have gone from smoking ordinary cigarettes to using the new products. These are people who believe the new products have helped them reduce their intake of addictive and dangerous substances. If it is true, this would be a valid point.

On the other side of the debate, are health officials who want to discourage smoking and reduce the harm it does. They are in a dilemma. They do not want to endorse any sort of smoking product. But if e-cigarettes are actually safer than traditional tobacco products or help people quit, it makes sense to allow them so existing smokers can move on to them. This points to legalizing the product but with strict regulations to discourage the new products from creating a new market – notably among youngsters.

This last possibility is extremely worrying to anti-smoking campaigners. They are so concerned about young people starting to use new sorts of smoking devices that they would prefer a total ban. Some campaigners dispute whether new products are actually safer. They say that just because the new products have lower quantities of carcinogenic substances, this does not mean a lower risk. These products are new, so scientists do not have data on long-term effects.

Where does this leave our policymakers?

The government put proposals to the legislative council two months ago. If you weren’t following this story, would you be surprised to learn that all sides are unhappy with the government’s plan?

The basic approach is to treat the new products quite similarly to existing tobacco products in terms of tax and marketing and sales regulation. The industry dislikes this as e-cigarettes do not contain tobacco as such. The anti-smoking campaigners are angry because they believe young people will find the new habit – “vaping” – trendy.

The legislation is still in the pipeline, and we will hear far more argument about it.

One lesson we should draw from this is that perhaps there is no “correct” solution to this question.

From a pragmatic point of view, we should remember that if people want these new products, they can get them online or when travelling overseas. If users believe they are doing less harm than the old-style cigarettes, we probably should not stop them. (Even strong opponents accept that the new products could be distributed as treatments to help people quit smoking.)

At the same time, the authorities, educators and parents should all play a part in making sure kids know that smoking in any form is bad for health, and not cool.

We have to realize that, at the end of the day, government cannot totally control what individuals do with their personal lives.

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